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Bacterial
Vaginosis
(BV)  |
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What is bacterial vaginosis?
Bacterial
vaginosis (BV) is the most common vaginal infection in women of
childbearing age. It is sometimes accompanied by discharge, odor, pain,
itching, or burning.
How common is bacterial vaginosis?
Scientific
studies suggest that BV is common in women of reproductive age. In the
United States, as many as 16 percent of pregnant women have BV. This
varies by race and ethnicity, from 6 percent in Asians and 9 percent in
non-Hispanic whites to 16 percent in Hispanics and 23 percent in African
Americans.
How do people get bacterial vaginosis?
The cause of
BV is not fully understood. BV is associated with an imbalance in the
bacteria that are normally found in a woman's vagina. The vagina
normally contains mostly "good" bacteria, and fewer "harmful" bacteria.
BV develops when there is a change in the environment of the vagina that
causes an increase in harmful bacteria.
Not much is known about how women get BV. There are many
unanswered questions about the role that harmful bacteria play in
causing BV. Any woman can get BV. However, some activities or behaviors
can upset the normal balance of bacteria in the vagina and put women at
increased risk including:
- Having a new sex partner or multiple sex partners,
- Douching, and
- Using an intrauterine device (IUD) for contraception.
It is not
clear what role sexual activity plays in the development of BV. Women do
not get BV from toilet seats, bedding, swimming pools, or from touching
objects around them. Women that have never had sexual intercourse are
rarely affected.
What are the signs and symptoms of bacterial
vaginosis?
Women with
BV may have an abnormal vaginal discharge with an unpleasant odor. Some
women report a strong fish-like odor, especially after intercourse.
Discharge, if present, is usually white or gray; it can be thin. Women
with BV may also have burning during urination or itching around the
outside of the vagina, or both. Some women with BV report no signs or
symptoms at all.
What are the complications of bacterial
vaginosis?
In most
cases, BV causes no complications. But there are some serious risks from
BV including:
-
Having BV
can increase a woman's susceptibility to HIV infection if she is
exposed to the HIV virus.
-
Having BV
increases the chances that an HIV-infected woman can pass HIV to her
sex partner.
-
Having BV
has been associated with an increase in the development of PID
following surgical procedures such as a hysterectomy or an abortion.
-
Studies
suggest that pregnant women are at increased risk for complications of
BV.
How does bacterial vaginosis affect a pregnant woman and her
baby?
Pregnant
women with BV more often have babies who are born premature or with low
birth weight (less than 5 pounds).
The bacteria that cause BV can sometimes infect the uterus (womb)
and fallopian tubes (tubes that carry eggs from the ovaries to the
uterus). This type of infection is called pelvic inflammatory disease
(PID). PID can cause infertility or damage the fallopian tubes enough to
increase the future risk of ectopic pregnancy and infertility. Ectopic
pregnancy is a life-threatening condition in which a fertilized egg
grows outside the uterus, usually in a fallopian tube which can
rupture.
How is bacterial vaginosis diagnosed?
A health
care provider must examine the vagina for signs of BV and perform
laboratory tests on a sample of vaginal fluid to look for bacteria
associated with BV.
What is the treatment for bacterial
vaginosis?
BV can
increase a woman's susceptibility to other STDs, such as chlamydia and
gonorrhea. Although BV will sometimes clear up without treatment, all
women with symptoms of BV should be treated to avoid such complications
as PID. Male partners generally do not need to be treated. However, BV
may spread between female sex partners.
Treatment is especially important for pregnant women. All
pregnant women, regardless of symptoms, who have ever had a premature
delivery or low birth weight baby should be considered for a BV
examination and be treated when necessary. All pregnant women who have
symptoms of BV should be checked and treated.
Some physicians recommend treating all women for BV, regardless
of symptoms, prior to surgery for hysterectomies or abortion to reduce
their risk of developing PID.
BV is treatable with antimicrobial medicines prescribed by a
health care provider. Two different antibiotics are recommended as
treatment for BV: metronidazole or clindamycin. Either can be used with
non-pregnant or pregnant women, but the recommended dosages differ.
Women with BV who are HIV-positive should receive the same treatment as
those who are HIV-negative. BV can recur after
treatment.
How can bacterial vaginosis be
prevented?
BV is not
completely understood by scientists, and the best ways to prevent it are
unknown. However, it is known that BV is associated with having a new
sex partner or having multiple sex partners. It is seldom found in women
who have never had intercourse.
The
following basic prevention steps can help reduce the risk of upsetting
the natural balance in the vagina and developing BV:
-
Limit the
number of sex partners.
-
Do not
douche.
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Use all of
the medicine prescribed for treatment of BV, even if the signs and
symptoms go away.
Where can I get more information?
Division of
STD Prevention (DSTDP)
Centers for Disease Control and
Prevention
http://www.cdc.gov/std/
Personal
health inquiries and information about STDs:
CDC
National STD and AIDS Hotlines
(800) 227-8922 or (800)
342-2437
En Espanol (800) 344-7432
TTY for the Deaf and Hard of
Hearing (800) 243-7889
Resources:
CDC
National Prevention Information Network (NPIN)
P.O. Box
6003
Rockville, MD 20849-6003
1-800-458-5231
1-888-282-7681
Fax
1-800-243-7012 TTY
E-mail: info@cdcnpin.org
http://www.cdcnpin.org/scripts/index.asp
American
Social Health Association (ASHA)
P. O. Box 13827
Research
Triangle Park, NC 27709-3827
1-800-783-9877
http://www.ashastd.org/
STD questions: std-hivnet@ashastd.org
Sources
American
Social Health Association. Sexually transmitted
diseases in America: How many cases and at what cost? Research
Triangle Park, NC, 1998.
Centers
for Disease Control and Prevention. Sexually transmitted diseases
treatment guidelines 2002. MMWR 2002;51(no. RR-6
Hillier, S.
and Holmes, K. Bacterial vaginosis. In: K. Holmes, P. Mardh, P. Sparling
et al (eds). Sexually Transmitted Diseases, 3rd Edition. New York:
McGraw-Hill, 1999,
563-586. | 
